Cost of Care Manager

Elevance Health • Waukesha, IN

1d • Hybrid

About The Position

Leads and manages multiple cost of care initiatives enterprise wide (e.g. local, within each state, across business segments and at the enterprise level) and drives their execution. Understands, predicts and implements measures to control healthcare costs and to make healthcare more affordable for our customers. Develops, manages, oversees, and executes new and innovative initiatives to manage rising costs and enhance the company's market competitiveness.

Requirements

• Requires a BS/BA degree and minimum of 5 years relevant experience in Health Care; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Prior experience with provider network contracting, provider networks, claims, finance, and operations
• SQL experience strongly preferred
• Experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical analysis and healthcare modeling preferred
• MBA, MHA, MA preferred
• PMP or Six Sigma Green Belt preferred

Responsibilities

• Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, and financial operations
• Oversee the identification of potential cost of care savings opportunities through complex analytics via partnering with the cost of care analytics team, to develop action plans, benefits and risk assessments and overseeing and partnering with the actuarial team to develop and ensure accurate savings quantification
• Champions cost of care initiatives, negotiates for human capital resources, and partners with care management, claims, IT, and business partners
• Manages and presents cost of care projects to senior leadership including State Plan Presidents
• Serves on local and enterprise committees
• Plans, leads and oversees cost of care planning meetings and tracks and reports on cost of care projects

Benefits

• In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees